Prevalence of Vitamin B and folic acid deficiency in HIV-positive patients and its association with neuropsychiatric symptoms and immunological response.

Background: Deficiency of micronutrients is prevalent even before the development of symptoms of HIV disease and is associated with accelerated HIV disease progression.

Aims: This study evaluates the prevalence of folate and Vitamin B deficiency in HIV-positive patients with or without tuberculosis (TB) and its association with neuropsychiatric symptoms and immunological response.

Settings And Design: Cross-sectional, observational study in an outpatient setting.

Patients And Methods: Four groups of HIV-positive patients with TB (Group I), HIV-positive patients with neuropsychiatric symptoms (Group II), HIV-positive patients without neuropsychiatric symptoms or TB (Group III), and HIV-negative controls with neuropsychiatric symptoms (Group IV). Vitamin B and folate estimation was done using carbonyl metallo-immunoassay method.

Statistical Analysis Used: ANOVA, Kruskal-Wallis and Mann-Whitney, Pearson's correlation.

Results: The prevalence of folic acid deficiency was 27.1% in the Group I, 31.9% in the Group II, 23.4% in the Group III, and 32% in the Group IV being higher in patients with neuropsychiatric symptoms in both HIV and non-HIV patients. The prevalence of Vitamin B deficiency was 18.8% in Group I, 9.1% in Group II, 4.8% in Group III, and 16.7% in Group IV. The patients with folate deficiency had more severe depression and anxiety.

Conclusion: Nearly, 30% of the HIV patients had a folic acid deficiency, and about 10% of the HIV patients had Vitamin B deficiency. The folate deficiency was highest among neuropsychiatric patients with or without HIV infection and Vitamin B deficiency was higher among HIV patients with TB.